It’s summer and children are outside playing sports, attending camps, and working summer jobs. They’re on playgrounds, at friends’ homes, and swimming. While we want them to have fun (it’s summer break after all!), it’s important to be mindful of potential injuries. More activity means more opportunity for accidents. As a pediatric urgent care physician, I’ve seen it all.
As parents and caregivers, we should be aware of possible injuries, what we can do to prevent them, and what we should do once an injury has occurred. Here are some of the most common summertime injuries, what to expect, and how to respond.
Concussions
Head injuries are a common risk in summertime sports and recreation. Concussions can happen when there’s a direct blow to the head or a blow anywhere on the body which results in a sudden movement of the head.
Concussion symptoms can include brief changes in awareness or thinking, dizziness, vomiting, changes in vision, and headache. Most concussions can be managed in an urgent care center, and prompt evaluation is crucial following a concussion. Physicians and advanced practice providers use specific criteria to determine which patients may need a head CT scan. Anyone meeting the specific criteria for a head CT scan should be evaluated at a pediatric emergency department and directed to an appropriate facility for a CT scan. Post-concussion care and planning for return-to-play are important and arranged following an evaluation.
To help prevent concussions, kids should always wear safety helmets when riding bikes, scooters, skateboards, and ATVs.
Mouth and Facial Injuries
Most mouth and facial injuries are caused by falling or being hit by an object during sports or other recreation. Depending on the injury location, most scalp, facial, and lip lacerations can be repaired at a pediatric urgent care clinic using stitches, skin staples, or skin glue. All kinds of distraction tricks and a numbing solution are used to help take the scary out of these procedures for kids.
Most nasal injuries do not cause fractures but can result in nosebleeds, swelling, and bruising. Most tongue lacerations do not need to be sutured except for those that cause a forked tongue injury.
In the event of an injury to baby teeth, a pediatric dentist should be consulted. Typically, it is not as urgent as an injury to permanent teeth, which usually require prompt evaluation by a dentist.
Severe facial injuries may need CT imaging to rule out a fracture. A CT scan can only be performed at an emergency department. So if a child seen at an urgent care needs a CT scan, they will be referred to an ER.
Broken Bones
Most broken bones can be X-rayed and treated at a pediatric urgent care clinic. These injuries include mildly angulated breaks where the bone appears to be bent. It is important to distinguish between a fracture and a soft tissue injury as soon as possible so the appropriate treatment can be initiated.
Most fractures (broken bones) will be treated at an urgent care center with either adjustable EXOS braces, fiberglass braces, simple splints, or orthopedic boots, depending on the location of the fracture. Following this evaluation, the patient will be directed to appropriate orthopedic follow-up care.
Open fractures (where the bone is exposed through the skin) should be evaluated in a pediatric emergency department.
Sprains and Muscle Strains
Sprains and strains are among the most common injuries seen in pediatric urgent care. Sprains are when there’s an injury to the ligaments that hold bones together at joints. Strains are caused by over-stretching the muscles.
Early management includes supportive care such as rest, ice, and anti-inflammatory medications. Depending on the severity, braces can be used for a wrist, knee, or ankle injury. Slings or orthopedic walking boots may be needed.
Overuse Injuries
These injuries result from repeated stress on a joint, muscle, tendon, or bone. Examples include tennis elbow, pitcher’s elbow, jumper’s knee, Sever’s syndrome (affecting the heel), and Sinding-Larsen-Johansson syndrome, which affects knees.
These types of injuries are most common in children who train in only one sport and continually stress the same area of their body. Managing overuse injuries includes supportive care and orthopedic and/or physical therapy follow-up.
Cuts and Bruises
These injuries are very commonly seen in pediatric urgent care clinics. Abrasions are scrapes to the skin that are managed with simple wound care. Contusions are bruises that are managed with pain control only. Lacerations can be repaired at a pediatric urgent care clinic with sutures, skin staples, or skin glue, depending on the location and severity of the wound.
Sunburn
Summertime means more sun exposure. Most sunburns are first-degree (superficial) burns that are managed with supportive care and anti-inflammatory medication. Second-degree sunburns are deeper and cause blister formations.
Children and teens with extensive first-degree or second-degree sunburn should be evaluated at a pediatric urgent care clinic. Extensive second-degree sunburns may be referred to a burn center.
Using sunscreen and covering with clothes, hats, and sunglasses help prevent sunburns.
Heat Exhaustion and Heat Stroke
Exposure to high temperatures or strenuous physical activity can cause these heat-related illnesses. Heat exhaustion symptoms include heavy sweating, dizziness, nausea, fatigue, muscle cramps, and rapid pulse. It can be evaluated and treated in a pediatric urgent care setting.
Heat stroke is a much more critical manifestation of heat exposure and requires immediate medical attention in an emergency room. Symptoms include confusion, altered mental status, very high core body temperature (over 104 degrees), and no sweating.
To prevent heat exhaustion and heat stroke, children and adults should stay hydrated, seek shade, and take frequent breaks during outside activities.
Near-Drowning Incidents
Near-drowning happens when a child cannot breathe because of being underwater for a prolonged time. It can occur in young children who are in water and are not able to swim or in young people who may be injured or impaired due to alcohol or drug use.
Symptoms may include unresponsiveness or decreased responsiveness/confusion, cool or discolored skin, vomiting, cough, visibly swollen abdomen, and fast or slow heartbeat.
Seek medical attention immediately if your child experiences near-drowning. Provide constant supervision for children who cannot swim, swim lessons for all children, and careful play while in water to prevent near-drowning.
I’ve seen a lot of summer injuries during my twenty-nine years as a pediatric ER and urgent care doctor. Summertime should be a fun, memorable season for kids, and participating in outdoor activities helps their physical and mental development. It’s our job as parents and caregivers to be aware of the risks for injuries and have a plan for care should it be necessary.
